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Working as an orthopedic surgeon in one country and as a cashier at a hot dog stand in another sounds ridiculous, but that’s the story of Marwan, one of 1.3 million underemployed newcomers in the United States.

As executive director of San Francisco-based Upwardly Global, Nikki Cicerani works to reverse that trend and help highly-skilled immigrants like Marwan rebuild their professional careers and reach their full potential.

Upwardly Global is one of four awardees of the Migration Policy Institute’s second annual E Pluribus Unum Prizes that acknowledge outstanding immigrant integration initiatives around the country. They were selected from 340 applicants.

MPI President Demetrios Papademetriou declared the recognition of the awardees’ efforts as one of “hope for all of those that fear we have lost our way, that after 500 years the American immigration machine has stalled.”

According to the Department of Homeland Security’s Office of Immigration Statistics, there are 4.1 million legal immigrants who have come to the United States in the last 10 years, with 463,000 new arrivals in the 2009 fiscal year. Over half of the new immigrants in 2009 were married with an average age of 31 years.

Papademetriou said 850 groups working to serve these newcomers have applied for the award over the last two years. They are proof that the machine is working just fine, from providing English-language services to opening welcome centers and immigrant-owned community banking institutions for newcomers who want to be better integrated into American society.

Cicerani said major barriers these immigrants face are the lack of knowledge of the U.S. job search, the lack of connections and know-how of self-marketing and interviewing in a manner U.S. employers expect.

“When somebody asks you ‘tell me about your greatest weakness?’ it can be one of those cultural questions where it would be bizarre for [newcomers],” she said. “Or even more bizarre in many cases for those coming from other countries is ‘what’s your greatest accomplishment?’ and have to speak in a self-promotional way.”

With the help of Upwardly Global, Marwan, an Iraqi refugee who for safety reasons could not share his last name, gained the mentoring he needed and was able to obtain a position back in his field of study earning $37,000 annually with benefits.

“We are trying to insert these programs more directly into the immigration debate,” said MPI co-director, Margie McHugh. Implementing services for immigrants at the local level should be brought into the discussion, she said.

Illinois has been a successful model since it became the first state in the country to adopt an executive order in 2005, making immigrant integration a deliberate priority of the state.

Another award winner is The Illinois New Americans Integration Initiative, a partnership between the Illinois Department of Human Services and the Illinois Coalition for Immigrant and Refugee Rights. Grace Hou, IDHS assistant secretary of programs, said Illinois has seen an increasingly large percentage of immigrant Americans.

“Too long their needs have gone unmet, and we are just catching up,” she said.

The initiative has operated a set of programs that make sure an array of training and other services provided by the department are accessible to limited English proficient customers. Emphasizing immigrant integration as part of Illinois state policy has prevented targeted cuts for programs serving immigrants. Hou said this has been helpful during the recession and has inspired others to follow suit.

“This is a partnership that has led the way for Maryland and a block of other states across the nation,” said Michael Fix, MPI co-director. “It’s one of the most systematic efforts to make a large state agency accessible to non-English speaking clients.”

While programs have been relatively protected in Illinois, the recession is having a major impact on immigrant services because of state budget shortfalls. McHugh identified characteristics among this year’s pool of applicants that have kept them afloat during hard economic times.

“Many had strong self-funding models or generated income to support themselves,” McHugh said. “And a higher number were organizations that had been around for a long time.”

One such group that appeared to be largely untouched by the recession is the Latino Community Credit Union, a member-owned nonprofit financial institution with 10 branches across North Carolina. The LCCU has a staff of all immigrants and offers bilingual financial services and financial education to the Latino community and immigrants without bank accounts.

It started out as a grassroots experiment to curb violence against Latino immigrants in Durham, who were targeted as “walking ATMs” because they carried cash in their pockets due to a lack of access to checking accounts.

“With the creation of the credit union, Latinos have a safe place to keep our money, an institution that truly cares, where people can pronounce our names right and also who share our dreams,” said board chairman Edgardo Colon-Emeric.

Now LCCU has 54,000 members and is the fastest growing credit union in the country.

“It not only saves our money but saves our lives,” said LCCU CEO Luis Pastor, who began at the organization as a volunteer after he came to the United States from Spain in 2000.

While a few of the recognized initiatives have emerged in the last decade, a fourth award winner, the Tacoma Community House, was founded a century ago to help the 4000 Italian immigrants and their children settle in Washington state. Now TCH works with immigrants and refugees from over 80 countries, helping them learn English, become U.S. citizens and contribute to civic life.

The McDonald’s Corporation also received an honorable mention for its English Under the Arches program, providing free English instruction during work hours to help its immigrant employees improve their customer relations and management skills.

Each prize recipient received a check for $50,000 to expand the organization’s work in immigrant integration.

“Too often the immigration debate is heavy on drama and rhetoric and too short on solutions,” remarked Suzette Mesters of the J.M. Kaplan Fund that supports the E Pluribus Unum awards. “What I hope today is that the solutions take center stage.”